JPS60225575A - Heat exchanger - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to a heat exchanger used to control the temperature of blood flowing in an extracorporeal blood circuit, such as a blood bubble oxygenator.

[Prior art and its problems]

Many types of cardiac surgery require the use of an extracorporeal cardiopulmonary bypass circuit while the surgical procedure is being performed. The role of such a bypass circuit is to essentially take over the functions of the heart and lungs while a surgical procedure is being performed.

This type of extracorporeal circuit is used to oxygenate and pump blood in the same way that the heart and lungs normally oxygenate and pump blood.

As is well known, the basic elements of such a bypass circuit are:
A pump that forces blood to circulate through the circuit and returns it to the patient's body, and an oxygenator that adds oxygen to the blood and removes carbon dioxide.

The most commonly used method for adding oxygen to the blood is to introduce small bubbles of oxygen-rich gas into the blood.
It allows oxygen to be absorbed into the blood. Although many different types of bubble oxygenators have been developed, bubble oxygenators generally consist of an oxygenate region, a defoaming region, and an arterial reservoir. be done.

Oxygen and other gases are introduced into the oxygenation region through small holes or porous sides. Each tube or porous member creates a plurality of small air bubbles that are dispersed into the blood. As the gas and blood mix with each other,
Oxygen is absorbed into the blood and carbon dioxide is liberated. In most devices, the majority of oxygenation occurs in this oxygenation region. However, in some types of devices, blood remains within the oxygenated region for a short residence time.

That is, oxygen addition occurs continuously even when the blood passes through the subsequent degassing region.

When oxygen is bubbled into the blood in a bubble oxygenator, a certain amount of bubbles inevitably occur. This foam, as well as any air bubbles trapped therein, must be removed from the blood before it is reinfused into the patient. Otherwise, the trapped air bubbles may form emboli and cause serious harm to the patient. Defoaming is generally accomplished by passing the blood across a large surface area material that has been treated with a defoaming agent.

Blood then flows into the arterial reservoir. This arterial reservoir is the area from which degassed blood is collected before being reinfused into the patient. This arterial reservoir acts as a safety device to avoid accidental pumping of air into the blood vessel. In the event that blood supply to the oxygenator is interrupted due to an accident, this arterial reservoir contains enough blood to allow the perfusator to stop output from the oxygenator before air enters the artery. must be accommodated.

When performing cardiac surgery while circulating blood through an extracorporeal circuit that includes an oxygenator, it is critical to be able to control the temperature of the blood. As is well known, when blood is allowed to flow outside a multibody for a long period of time, the blood tends to be cooled to room temperature.

Although this cooling of the blood may or may not be desirable at certain points in the surgical procedure, it is important to warm the blood to normal body temperature and bring the patient's body temperature back to normal when the procedure is about to be completed. It is desirable to return to body temperature.

Furthermore, it is now common practice to use hypothermia during cardiac surgery. Lowering body temperature can significantly reduce the oxygen demand required for various biological vessels. In particular, according to the literature, the oxygen demand of the patient is 30°C.
It decreases to about 1/3 at 25℃ and about 115 at 20℃. Hypothermia is particularly useful for protecting vessels such as the kidneys, heart, brain, and liver, which have high oxygen uptake and require high perfusion. Mild (37
~32℃), Moderate (32~28℃), Deep (
28-18℃), and Profound (18-0℃)
Hypothermia is used in all cases.

More rate hypothermia is generally found to be sufficient for routine open heart surgery. However, deep and grofound hypothermia are recommended in cases where
It is particularly desirable for surgical repair of congenital defects in infants and children.

The most important consideration when using hypothermia is the time required to cool and reheat the blood.

The time required to change blood temperature is added to the length of the surgical procedure. If this time is minimized, the amount of time it takes to perform an open heart surgery is increased and the total time required to perform one operation is minimized. Clearly, reducing these times will reduce the general damage sustained by the patient. Therefore, it is important that the heat exchanger be able to change blood temperature as efficiently as possible.

Thus, especially when using hypothermia, a means of controlling the temperature of the blood within the extracorporeal circuit is critical. Various types of heat exchangers have been used in the past to control blood temperature during cardiac surgery.

Many of the early heat exchangers were not built into the oxygenator itself, but rather were placed in the extracorporeal circuit with the oxygenator. In other words, the heat exchanger was the third major element in the extracorporeal circuit. Therefore, the extracorporeal circuit consisted of a pump mechanism, an oxygenator, and a heat exchanger. Heat exchangers can be implemented in various ways.

Typical heat exchangers use hollow coils or hollow plates through which a heating medium is circulated. Typically, the heating medium is tap water, which is readily available in the operating room.

The heat exchanger and oxygenator were then mounted within a single structure (generally made of molded plastic). The configuration of the oxygenator as well as the heat exchanger remained essentially unchanged. The blood first flows through the oxygenator and, after being fully oxygenated, flows into the heat exchanger. However, by connecting the two elements within a single structure, certain problems previously encountered are overcome.

ff1j It is possible to eliminate various types of cheating, and blood can easily flow through both the oxygenator and the heat exchanger without special consideration regarding the positioning of the extracorporeal circuit. We were able to arrange the heat exchanger and oxygenator in a similar manner.

In further devices, the heat exchanger and oxygenator are located in one integrated enclosure.

In these devices, it is common to mix blood and oxygen in an oxygenation zone and then pass the blood to a heat exchange zone. After passing through the heat exchange region, the blood flows through the degassing region and is routed to the arterial reservoir for reinfusion into the patient.

Thus, heat exchange and oxygen addition functions are combined into one single device. However, although a heat exchanger is incorporated into the oxygenator, this heat exchanger is of a generally similar type to those previously used.

Examples of such an integrated oxygenator and heat exchanger include a Haruma-Y type oxygenator and a 5hiley type oxygenator. The Harvey oxygenator is a disposable, hard shell, concentric, bubble oxygenator (see US Pat. No. 3,768,977). The oxygenator is mounted and suspended by brackets that support the top and bottom of the oxygenator. Venous return and cardiotomy drainage and gas flow towards the bottom of the oxygenator. The dispersion process is made from a sintered plate, which creates cells of various sizes. Oxygenated blood flows upward through a plurality of parallel vertical tubes.

An integral heat exchanger surrounds these chambers and is in contact with the blood through the oxygenation and degassing regions and the arterial reservoir.

The 5hifey type oxygenator uses the same basic elements, but with a different heat exchanger (U.S. Patent 4.OQ
, No. 264). In a 5hiley type device, the heating medium flows through the coil. As in a Harvey-type device, blood reaches the coil after being oxygenated but before being degassed. The outside of the 5hiley type heat exchange coil is provided with a continuous, hollow spiral lip. The ribs are used to make heat exchange more efficient by increasing the residence time of the blood as it moves through the heat exchanger.

Other devices include variations on the Harv@y or 5h11ay principles. For example, two coils similar to those used in the 8hil@y type device are used. Additionally, some modified profile of the Harvey basic structure has been used, with a series of parallel tubes running the length of the oxygenator. However, in order to provide sufficient heat exchange, most conventional devices use spiral and serpentine blood flow paths, which increase blood residence time and reduce boundary wave effects. We are trying to improve exchange efficiency. however.

Both conventional devices require an unreasonable increase in the surface area exposed to the blood in order to provide adequate heat exchange, thereby increasing damage to the blood such as hemolysis. .

Pisrr@M * Ga1lstti is r Hea
In his book entitled rt-LungBypass J, he sets out several criteria for acceptable heat exchangers.

The standards are as follows.

(1) Materials used for heat exchangers must be non-toxic. It is clear that interest that leaches into the blood cannot be used. Therefore, many conventional devices use stainless steel heat exchangers.

Although stainless steel is essentially non-toxic, it is not particularly compatible with blood.

(2) Heat exchangers must be easily cleanable or disposable.

Devices using complex flow paths with complex coil geometries are extremely difficult to clean.

(3) There must be no internal fluid leakage. If water or other heating medium leaks into the blood, the impact on the patient can be devastating.

(4) Heat exchangers must not significantly increase blood flow resistance. The spiral flow path formed in conventional devices does nothing but significantly increase flow resistance.

(5) Heat exchangers must minimize damage to blood. The more complex the flow path and tubing, the greater the potential for damage to the blood. Furthermore, blood damage is more likely to occur when blood is exposed to stainless steel than when blood is exposed to more biocompatible surfaces such as various plastics.

(6) Heat exchangers must be efficient. These criteria include maximizing heat exchange, minimizing exposed surface area, and minimizing the volume of blood required to prime the oxygenator and heat exchanger assembly. is included.

(7) Finally, heat exchangers must be fairly inexpensive.

None of the prior art devices fully achieves these objectives stated by Ga1lstti.

Therefore, what is needed in the art is a heat exchanger that can be used in conjunction with a bubble oxygenator and that more reliably meets the Galetti criteria. In particular, there is a need for an efficient heat exchanger that does not use spiral or tortuous flow paths and provides blood contact only with biocompatible surfaces. There is also a need for a heat exchanger that is simple in construction and operation, and that is easy and inexpensive to manufacture. In particular, the heat exchanger must be easily integrated into standard bubble oxygenators.

[Purpose of the invention]

The general purpose of the present invention is to provide significant improvements over the prior art in the respects identified by Ga1lstti.

It is therefore an object of the present invention to provide a heat exchanger usable in a bubble oxygenator, which can be easily integrated and stored within the oxygenator.

It is another object of the present invention to provide a heat exchanger that provides efficient heat exchange while minimizing surface area exposed to blood and requiring little priming volume. It is.

Yet another object is to provide a heat exchanger capable of rapidly cooling or heating blood, thereby minimizing the time required for a surgical procedure.

Another object of the present invention is to provide a heat exchanger that can minimize damage to blood.

Another object of the invention is to provide a heat exchanger that is simple in construction and operation and can be easily and inexpensively manufactured.

[Summary of the invention]

In a preferred embodiment of the invention, the heat exchanger of the invention has a generally cylindrical shape. The heat exchange core is completely closed except for two fittings at the top of the device. These two joints are for introducing the heat medium into the heat exchange core and then delivering the heat medium to the outside of the heat exchange core. The heat transfer medium flows into the core and is conveyed through tubes provided inside the core towards the bottom of the core and then flows upwardly to heat or cool the outer wall of the heat exchange core as required. Finally, the heating medium exits the core via an outlet joint provided at the top.

Although the heat exchanger can be used separately from the oxygenator, the present invention contemplates housing the heat exchanger within a conventional bubble oxygenator. The heat exchanger can be placed within the oxygenator between the oxygenator and the degassing zone.

The shape of the heat exchange surface of the device of the present invention is such that the surface exposed to blood is significantly smaller than that of conventional devices, particularly devices using coil-type heat exchangers. The heat transfer efficiency of the device according to the invention is significantly increased, giving the advantage of simplified construction and assembly. The heat exchange core of the present invention minimizes damage to the blood because the blood can flow upwardly forming a straight flow path along the smooth outer wall of the heat exchange core. The heat exchange surface is not interrupted by irregularly textured surfaces. Such irregular surfaces are expensive to manufacture and tend to damage blood cells. If desired, this heat exchange core can be inserted into a complementary plastic container. The container is shaped to disrupt boundary layer effects in the blood stream and direct the blood into contact with the smooth surface of the heat exchange core.

Other objects and advantages of the present invention will become apparent from the following description of embodiments thereof with reference to the accompanying drawings.

〔Example〕

Next, the present invention will be described in detail with reference to the accompanying drawings. Similar components are designated by the same reference numerals throughout the different drawings. FIG. 1 is a cross-sectional view of a preferred embodiment of the invention. The heat exchange core 10 has a substantially cylindrical configuration (see also FIG. 3).

In the preferred embodiment, the outer wall 12 and bottom wall 14 of the heat exchange core 10 are constructed from relatively thin aluminum. This aluminum structure can be coated with a thin layer of biocompatible material. The aluminum structure can be coated with polytetrafluoroethylene, although the biocompatible material can be polyurethane or other similar polymers.

Therefore, the outer surface of the heat exchange core 10 can be readily used in contact with blood in a bubble oxygenator.

The heat exchange core 10 can also be provided with a top 16. The top 16 can be configured as part of the heat exchange core 10 or as a reusable, sharpened lid. In either platform,
The function of the top 16 is the same: it serves to seal the heat exchange core and to act as a support structure for any fittings necessary to operate the heat exchanger.

In the preferred embodiment of the invention shown in FIG. 1, this top 16 is provided with two heat exchange fittings. The purpose of these joints is to introduce the heat medium into the device and to discharge the heat medium that has flowed through the device. Joint 18 is an inlet joint, and joint 20 is an outlet joint. Either fitting can be constructed from standard fittings commonly used to attach hoses of the desired diameter.

Tubes 22 are arranged within the heat exchanger. The tube 22 has an enlarged funnel portion 24 which communicates with the inlet fitting 18 and the interior of the tube 22 . The lower end 26 of the tube 22 is for conveying the heating medium towards the outer wall 14.

A filling body (plug) 28 is arranged within the heat exchange core 10 . This packing 28 occupies the central part of the heat exchange core 10, leaving space for the heating medium to flow around the packing 28 and towards the outer wall 12 as efficiently as possible. Therefore, in order to maintain the temperature of the outer wall 12 and the bottom wall 14, a smaller container of heat medium is required.

Typically, a hose is attached to the inlet fitting 18 to convey water or other heat medium at the desired temperature.

The heating medium flows from there into the heat exchanger and downwardly through tubes 22. The heat transfer medium then flows out of the lower end of the nozzle tube 22 and flows under the filling body 28 . When the heat medium reaches the lower end of the heat exchanger outer wall 12, the packing body 28 and the outer wall 12
and flows upward in the space 27 between. As the heat transfer medium flows along the outer wall 12 and bottom wall 14 of the heat exchange core 10, the heat transfer medium heats or cools the core 10.

Once the heat transfer medium reaches the top of the packing 28 it is collected in the upper reservoir 30 of the core and then discharged through the outlet fitting 20. This heating medium can be disposed of or recycled according to known methods.

This heat exchange core 10 can be manufactured extremely easily. This heat exchange core does not use a complex network of coils or tubes, nor does it require large-scale structures to be attached to its outer surface as in conventional devices. Therefore, this heat exchanger can be manufactured simply and easily. Also, this heat exchange core 10 can be manufactured very cheaply and therefore can be easily disposable. Furthermore, since the heat exchange core 10 has a simple cylindrical structure, it can be easily sterilized if necessary.

Therefore, this heat exchange core 10 fully satisfies the requirement that it be easily cleaned and sterilized or disposable.

This heat exchange core 10 has a simple basic structure and therefore operates safely. There are no complex series of seams or connections that could sometimes result in leaks in prior art devices.

The only connection to the interior of the heat exchange core is the outer wall 12 and m
This is the joint 31 with 5z6. This seam 31 is joined in a liquid-tight manner and its integrity can be easily tested. This heat exchanger thus satisfies the requirements of structural integrity and leak-free properties.

This heat exchange core 10 is complemented by a container 52 into which the core 10 is inserted. This core container 52 can also be configured as a separate container;
In the illustrated embodiment, this container 52 forms part of a bubble oxygenator 50 . A suitable example of a bubble oxygenator that may be used with the apparatus of the present invention is disclosed in US Patent Application No. 541,988, filed October 14, 1983.

FIG. 2 is a cross-sectional view of the heat exchange core 10 disposed within the bubble oxygenator 50. The heat exchange core 10 is placed in a container 52 such that a compartment is formed by the container 52 and the defoaming region 54 of the oxygenator 50, and the bottom of the compartment is A Sberger plate 56 is provided for introducing oxygen.

Oxygen and blood, which have passed through the bubbles 9-gar plate 56 and become bubbles, mix in the lower region of the bottom 14 of the heat exchange core 10. The oxygenated blood then flows upwardly through the space formed by the outer wall 12 of the heat exchange core 10 and the wall 52 of the degassing region 54 of the oxygenated Calorifier 50. The dimensions of this space 13 are intentionally limited to be small; this dimension is a function of the flow rate of blood through the heat exchanger. In the illustrated embodiment, this space 13 has dimensions of 0.
120 inches (3,05mm) to 0.040 inches (
1.02m). Blood flows through the outer wall 12 of the heat exchange core 1o
When flowing in space 13 along.

Heat exchange takes place between the blood and the heat exchange core 10.

Several features of the construction of this heat exchange core 10 and its use are unique and are illustrated in Figure 2. Firstly, when using the heat exchanger of the invention, the volume of blood required to brim the oxygenator 5o is very significantly reduced. Container 5
The bulk of the volume within the compartment formed by the walls 2 and the slat plate 56 is occupied by the heat exchange core 10. This is in sharp contrast to conventional devices such as those using coils. In conventional devices, the coil occupies a much smaller volume, so the volume difference had to be made up by adding extra blood to the device. for example,
The blood volumes required to prime a typical oxygenated unit using a coil-type heat exchanger or a tube store heat exchanger are 335 CC and 289 CC, respectively. In contrast, in the case of the present invention, the capacity required for priming is only about 27 CC. As previously discussed, it is important to minimize the volume of blood required for priming in order to minimize problems encountered in obtaining blood for transfusion and transfusing it to a patient.

Yet another important improvement in the device of the present invention is that the straight outer wall 12 of the heat exchange core 10 creates a straight, unobstructed blood flow path. In conventional oxygenators, especially those using coil-type heat exchangers, the blood flow path was not a vortex, but often had a meandering shape. In some types of coil-type heat exchangers, the outer wall of the heat exchange coil is provided with ribs or unevenness, so that the blood flow path becomes more meandering. This was specifically done to minimize boundary layer effects by disrupting the flow path, but it also makes the heat exchanger more complex and expensive to manufacture.

4 is a partially cut-away perspective view of another preferred embodiment of the heat exchange vessel 58, and FIG. 5 is a sectional view taken along the line 5--5 in FIG. The container 58 can be constructed as an integral part of the bubble atomizer 50, or it can be a separate component made of polycarbonate or other suitable moldable material. can. In this embodiment, the interior of container 58 is reticulated to present a series of integrally molded baffles 60.

Baffle 60 can be of various shapes and is preferably molded as part of the interior surface of container 58. In the illustrated embodiment, these baffles 60 are #
I is formed into a spiral shape/four turns, so that the outer shell of the container can be easily removed from the mold. In the device of the present invention.

The baffle 60 can be mounted on an inexpensive plastic or plastic shell, unlike prior art devices in which the baffle is formed on an expensive metal heat exchange core. It is of course possible to use other types of baffles. That is,
Baffles can be provided in any configuration that produces turbulent flow.

The baffle 600 function is to reduce the tendency for a fluid boundary layer to form along the inner wall 64 of the vessel shell 58 or the outer wall 12 of the heat exchange core 10 and to create turbulence.

It has been found that when the baffle 60 is provided on the inner wall 64 of the container 58, heat exchange is performed more efficiently. Powerful LoO interrupts the flow of fluid through the device, creating turbulence and disrupting the fluid boundary layer. This allows a more complete heat exchange between the blood or other fluid flowing through the device and the heat exchange core 10.

As will be described in more detail below, even without the baffle 60, this heat exchanger can exchange heat fairly effectively and has a high heat transfer coefficient. The use of baffles 60 increases the efficiency of the device and further increases the heat transfer coefficient.

The device of the present invention performs heat exchange very efficiently,
It is possible to minimize the surface area in contact with blood.

The heat transfer surface area in contact with blood is, for example, 2378 tffl in a typical tube heat exchanger and 1578 tffl in a coil heat exchanger. In contrast, in the device of the present invention, the surface area in contact with blood is approximately 26
It's only 3 CDs. However, the heat transferred by the device of the invention is comparable to that transferred by tube and coil heat exchangers. That is, the overall heat transfer coefficient (d/d, sm
, °C) is several times the overall heat transfer coefficient for coil and tube devices. Table 1 shows the heat transfer efficiency of the device of the present invention compared to typical coil and tube heat exchangers.

Below is the white table - Table 1 Fuka Erection 263 263 2β78 1,758
Blood side (cll) 2 milliliter 1 non-coagulant 27 27 289 335 or priming volume Ccd) 3 trebles 4' lie 9.6 9.6 8.2 5.2
Volume ratio (eked) 0.02 0.02 0.04 0.06
Thickness (cIn) 5・'Ino''・Number of ends 978 978 307 434
6.Riser'Tako audience button 422 3.33 343 2
From 3538℃ 26 (-) 7 Zenkai Gekihanei 4.62 6.37 0.67 1.6
6 (ad/cj, m℃) (Note) Each heat exchanger was tested three times separately.
It was calculated based on the average value. The test conditions are common to all tests and are as follows.

1. Air supplied to the sparger plate: 2 psi
g 2, coolant flow rate: 5.76 t/wk3 at 9°C, medium flow rate = 2.61 tl at 38°C 4, medium redeva: 7o
oom As can be seen from Table 1, the simple and inexpensive heat exchanger of the present invention is just as effective as other complex and expensive heat exchangers. That is, the overall heat transfer coefficient of the device of the present invention is several times higher than typical coil and tube heat exchangers, with and without baffles.

FIG. 6 further illustrates the effectiveness of the device of the present invention.

FIG. 6 is a graph showing a time-temperature heat exchange curve.

The vertical axis shows temperature (°C), and the horizontal axis shows time. The test conditions are the same as those shown in Table 1. The devices tested were a typical coil heat exchanger, a typical tube heat exchanger, and a device of the invention without baffles. As can be seen from this graph, the two embodiments of the present invention have efficiencies that are approximately close to that of the conventional device. Moreover, this efficiency is achieved with simple and inexpensive equipment; the present invention requires less liming volume than the 1710 ml of liming volume required in prior art equipment, and provides effective heat transfer. The surface is 15% smaller than conventional equipment.

Additionally, the heat exchanger of the present invention is suitable for use in a wide variety of situations. As shown in Figure 3, heat exchange core 1
0 can easily fit into conventional blood oxygenators. While it may be necessary to change the dimensions of the heat exchanger for use with a particular oxygenator, the device of the present invention does not require significant changes in shape. Additionally, the heat exchanger of the present invention can be readily used to provide heating and cooling in environments other than blood oxygenators. The device of the invention thus satisfies the last requirement above, that the heat exchanger must be flexible and adaptable for use in various situations.

In summary, the device of the present invention satisfies the various criteria required of an ideal heat exchanger and provides a significant improvement over the prior art.

The heat exchanger of the present invention is non-toxic since all surfaces exposed to blood are coated with biocompatible materials. Because of its shape, the heat exchanger of the present invention can be easily cleaned and sterilized. However, due to the low manufacturing cost, the heat exchanger of the present invention can be expected to be disposable. There are no connections or joints in the blood chamber, so 1.
The device of the present invention is free from leakage. Since the flow path is straight and free of obstructions, flow resistance does not increase significantly. Also, because the biocompatible coating is used and the blood flow path is straight, damage to the blood is minimized. The heat exchanger of the present invention can effectively transfer heat while bringing blood into contact with a small surface area. Additionally, the apparatus of the present invention does not require a briming vessel (about 1/1O of the priming volume required for typical conventional apparatus). It can be used with a bubble-type oxygenator, and can also be used for purposes other than bubble-type oxygenators.

The present invention may be embodied in various other forms without departing from its spirit or essential characteristics.

That is, the embodiments described above are merely non-illustrative;
It's not restrictive. It goes without saying that various modifications and changes can be made within the scope of the present invention.

[Brief explanation of drawings]

FIG. 1 is a longitudinal sectional view of an embodiment of the heat exchange core of the present invention, FIG. 2 is a longitudinal sectional view of a heat exchanger arranged in a puzzle-type oxygenator, and FIG. Figure 4 is an exploded perspective view of the heat exchanger core and bubble oxygenator shown in Figure 4. Figure 4 is a partially cutaway perspective view of an embodiment of the heat exchanger outer shell. FIG. 6 is a horizontal cross-sectional view of the heat exchanger shell along the time line illustrating the time required to cool a given amount of liquid from 38° C. to approximately 28° C. in the heat exchanger of the present invention and in a conventional heat exchanger. This is a temperature graph. DESCRIPTION OF SYMBOLS 10... Heat exchange core, 12... Outer wall, 13... Space, 14... Bottom wall, 16... Top, 18...
Inlet joint, 20... Outlet joint %22... Pipe, 24.
... Funnel part, 26 ... Lower end, 27 ... Space, 2
8... Filling body, 30... Upper reservoir, 31-
...Joint, 50...Bubble oxygenator, 52...
- Container, 54... Defoaming area, 56... Sparger plate, 58... Container, 60... Baffle, 64...
··inner wall. Margin below

Claims (1)

[Claims] 1. A heat exchanger for controlling the temperature of blood, comprising: an enclosed heat exchange core with a smooth heat exchange surface; and a heat exchanger for circulating a heat medium through the core. means; a container housing the core such that the heat exchange surface of the core is spaced a predetermined small distance from the wall of the container; and in a space between the heat exchange surface of the core and the inner wall of the container. A heat exchanger comprising a means for supplying blood. 2. The heat exchanger according to claim 1, wherein an inlet joint and an outlet joint are attached to the core to communicate the core with a heat medium source. Heat exchanger. 3. A pipe is disposed within the core, one end of the pipe communicates with the inlet joint, and the other end communicates with the bottom of the core, claim 2. Heat exchanger as described. 4. The heat exchanger according to claim 1, wherein a packing body is disposed within the core, and a space is formed between the packing body and the outer wall of the core. 5. The heat exchanger of claim 1, wherein said core has a smooth outer surface. 6. The heat exchanger according to claim 1, wherein the core is made of aluminum. 7. The heat exchanger according to claim 1, wherein the outer surface of the core exposed towards blood is coated with a biocompatible material. 8. The heat exchanger according to claim 1, wherein the outer surface of the core exposed towards blood is coated with polytetrafluoroethylene. 9. The heat exchanger according to claim 1, wherein the top of the core is a removable lid. 10. The heat exchanger according to claim 1, wherein the container is made of a plastic material. 11. The heat exchanger according to claim 1, wherein the inner wall of the container is smooth. 12. The heat exchanger according to claim 1, wherein the inner wall of the container is mesh-like. 13. A heat exchanger used by being connected to an extracorporeal blood circuit, wherein the surrounded part has a cylindrical member, and is attached to the cylindrical member and allows a heat medium to pass through the cylindrical member. It comprises an inlet joint and an outlet joint for circulation, and a container for storing the cylindrical member, the container having a narrow space between the outer wall of the cylindrical member and the inner wall of the container shell. A heat exchanger configured to allow blood to flow inside. 14. The heat exchanger of claim 13, wherein said cylindrical member has a smooth outer surface. 15. The heat exchanger according to claim 14, wherein the cylindrical member is made of aluminum. 16. The heat exchanger of claim 15, wherein the container is constructed of a plastic material. 17. The heat exchanger of claim 16, wherein said container has a smooth inner surface. 18. The heat exchanger of claim 16, wherein said container has a reticulated inner surface. 19. Claim 15, wherein the outer surface of the cylindrical member exposed to blood is coated with a biocompatible material.
Heat exchanger as described in section. 20. The heat exchanger according to claim 19, wherein the biocompatible material is NIJ tetrafluoroethylene. 21. A tube is disposed within the cylindrical member, and one end of the tube communicates with the inlet joint and the other end communicates with the bottom of the cylindrical member. heat exchanger. 22, a filler is disposed within the cylindrical member;
22. The heat exchanger according to claim 21, wherein a space is formed between the filling body and the outer wall of the cylindrical member. 23. The heat exchanger according to claim 22, wherein the top of the cylindrical member is a removable lid. 24. A heat exchanger for use in connection with a blood bubble oxygenator, comprising a substantially cylindrical aluminum core surrounded by the cylindrical core; a reservoir inlet and outlet fittings in communication with a source of heat transfer medium; a coating of biocompatible material applied to an outer surface of the cylindrical core to expose a smooth surface to blood; and a coating of biocompatible material within the cylindrical core. a colored tube, one end of which communicates with the inlet joint and the other end of which communicates with the bottom of the cylindrical core; and a filling body disposed within the cylindrical core, the filling body and the outer wall of the cylindrical core. a plastic container for storing the cylindrical core, the container being configured such that blood flows between the outer wall of the cylindrical core and the inner wall of the core container. A heat exchanger comprising: